Measles

Debate between Maria Caulfield and Daisy Cooper

Monday 22nd January 2024 Commons Chamber

[Maria Caulfield]

We have a vaccine damage payment scheme, which provides a one-off payment of £120,000. That is accessible for any vaccine that someone takes up, but I have to say that part of the problem is misleading information about the safety of vaccines. The measles vaccine is safe. At one point, we had eliminated measles in this country. Most children will be fine, with a mild illness, but we have had episodes of children getting encephalitis, which is a swelling of the brain that has lifelong consequences. We must move away from the narrative that vaccines are not safe. The measles vaccine is one of the safest vaccines people can have. I really do not think that that messaging is helpful.

[Daisy Cooper (St Albans) (LD)]

During the covid pandemic, my constituency of St Albans had one of the highest rates of vaccination. That was, in part, because of the work of our GPs and pharmacists, but we were also incredibly proactive at recruiting community champions, who could have those vital conversations to tackle hesitancy within particular pockets of our community. The Minister has mentioned pop-up clinics and vans, but she has not mentioned the role of community champions. Will she work with and support the directors of public health to recruit those community champions, who can have those vital conversations so that people can put their questions to people they know and trust?

[Maria Caulfield]

The hon. Lady is right that we used community champions during covid. We had some particularly effective campaigns for those communities that do not traditionally come forward for vaccinations, and that was done by using community leaders, faith leaders and trusted organisations within communities. We are doing that in the west midlands, in London and across the country.

Those people tell us that one of the key things that prevents Jewish and Muslim communities in particular from coming forward is their fear about the porcine vaccine. Just to reiterate, we have two types of MMR vaccine. Priorix does not contain gelatine and is safe and effective as an MMR vaccine. It is available on request, but we are also pushing out its availability so that people do not have to request it and it is offered up front. It is important that people know we have sufficient supply of the gelatine-free MMR product, and faith leaders, community groups and organisations are trying to get that message out to those two particular groups.

Strep A Treatments: Supply

Debate between Maria Caulfield and Daisy Cooper

Monday 19th December 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the supply of strep A treatments.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank the hon. Lady for her question. I know families are concerned about the recent outbreak of strep A in children. Although the vast majority of strep A cases are mild and can easily be treated with antibiotics, a small number of children have gone on to develop serious infections.

The UK Health Security Agency has already declared a national enhanced incident to co-ordinate our public response. Increased demand has led to some temporary supply issues, but I reassure Members on both sides of the House that we have stock of antibiotics and have taken a number of steps to deal with some of the supply issues.

First, we have worked at pace to help to ensure that there are supplies of vital medicines to meet the increased demand. Earlier this month, we convened roundtables with manufacturers of the preferred treatment, penicillin V, and with major UK wholesalers. We continue to work with manufacturers and wholesalers to boost supply to meet demand. The key issue is getting stock to pharmacies across the country. We have brought forward stock to make sure it gets to where it is needed, and we are expediting deliveries. Deliveries to wholesalers and pharmacies continues to be made, with more expected in the coming days and weeks.

Secondly, we have issued eight serious shortage protocols to allow pharmacists to supply not only alternative forms of penicillin, but alternative antibiotics. This will make things easier for pharmacists, general practitioners and, of course, patients. We have also added a number of antibiotics to our list of medicines that cannot be exported or hoarded.

Finally, we have updated advice across the board. Further guidance was given to GPs and pharmacists on Friday as part of the new SSPs. My Department has provided advice to colleagues in primary and secondary care on the management of the current supply issues. We have also held a cross-party briefing for MPs, and a “Dear Colleague” letter will go out later today.

I know this is a worrying time for families across the country, but I reassure them and people across the healthcare sector that we are managing the higher-than-normal number of strep A cases this winter and we have a range of medicines available.

[Daisy Cooper]

Across the country, parents are worried sick about the sharp rise in strep A infections. Tragically, strep A has caused the death of at least 19 children since September.

Last Thursday, just a few days after insisting there were no shortages, the Government finally admitted that there were indeed serious shortages of three penicillin medicines and issued serious shortage protocols to give pharmacists emergency powers to deal with supply issues. Why on earth did they take so long?

The Government will have seen the data on the number of prescriptions for strep A antibiotics, which started to rise more than a month ago. Health professionals, including Leyla Hannbeck, the chief executive of the Association of Independent Multiple Pharmacies, have been raising the alarm publicly for more than two weeks, and I called for a strep A summit to resolve the supply issues. Because the Government did not come clean sooner about the shortage of antibiotics, parents who are worried about their children have been left to travel to multiple pharmacies, GPs have had to find time to rewrite prescriptions and A&E departments have been overwhelmed by anxious parents and children who cannot access medical help when they need it.

Why have the Government taken so long to act? Did they not look at prescription data, or did they just ignore it? Why did the Secretary of State insist on television that there were no shortages, when GPs, pharmacists, directors of public health and parents all said that there were?

After shortages of lateral flow tests, hormone replacement therapy and so on—you name it—why are we in this position again? The Government seem incapable of forward planning, and we are stuck in a shortage groundhog day. Can the Minister update us on the Competition and Markets Authority investigation into the sharp rise in the prices of antibiotics?

Finally, we are in the lead-up to Christmas. Pharmacists have told me that some key contacts in the manufacturing companies are already on leave for the Christmas holiday. Families are making difficult decisions about the safety of their children and extended family. What action will the Government take now to ensure that families across the country can access the antibiotics they might need over the entire Christmas period?

[Maria Caulfield]

I reassure the hon. Lady that we have not waited to act. We have already issued serious shortage protocols, which are routine mechanisms when there is pressure on supplies. We have the stock of antibiotics in the country—as I outlined in my opening remarks, it is about supply issues. We are seeing five to six times the amount of antibiotics being prescribed at the moment. That is because the UK Health Security Agency has issued guidance to GPs, A&Es and healthcare professionals to lower the threshold of when they would normally give antibiotics. We are seeing significantly increased use of antibiotics. That is in addition to the prophylactic use of antibiotics by directors of public health, if they have had an outbreak locally. That is why we issued the initial SSPs already a couple of weeks ago so that pharmacists had flexibility in how they dispensed that medication. It is why on Friday we issued the new SSPs, which allow amoxicillin, clarithromycin, flucloxacillin, cefalexin, co-amoxiclav and erythromycin to be issued instead, if pharmacists do not have Penicillin V on their shelves. We are being as flexible as possible to give pharmacists that scope.

We are monitoring this issue on a daily basis. May I reassure people that while these are higher than usual incidences for this time of year, overall for this season we are not yet at the 2017, 2018 levels, where we had a significantly higher number of deaths? Strep A occurs not just in—[Interruption.] Hon. Members do not want to listen. I think I have said enough.

Oral Answers to Questions

Debate between Maria Caulfield and Daisy Cooper

Tuesday 6th December 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

My constituent is a victim of sexual misconduct by a medical professional, but they cannot challenge that professional’s fitness to practice because of the five-year rule. The General Medical Council wants that rule to be scrapped and the Government consulted on whether to get rid of it more than a year ago. Can the Minister say whether it is the Government’s intention to scrap it? Will she meet me to discuss how important it is that the GMC can explore whether a potentially dangerous medical professional who is still practising may be unfit to do so?

[Maria Caulfield]

I thank the hon. Lady for her campaigning on this serious issue. I am happy to meet her and I suggest that we also meet the patient safety commissioner, Henrietta Hughes, to discuss it further.

Ambulance Services and National Heatwave Emergency

Debate between Maria Caulfield and Daisy Cooper

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

I thank my right hon. Friend, who is absolutely right, because a number of factors are influencing the wait times at A&E. While delayed discharges are not increasing, there are still a significant number of them, which means that the NHS and local authorities have to be working together. That is why we have created the integrated care boards, which Opposition Members voted against, to better co-ordinate care between health and social care so that we can have better systems in place to discharge patients sooner. As I have said, we have 1,200 void beds, which is either due to infection control measures because of covid rates increasing or because patients cannot be discharged. I will be meeting every single ICB in the coming days, because as part of our winter preparation, we need to improve co-ordination in those areas.

[Daisy Cooper (St Albans) (LD)]

Last October, I revealed through a parliamentary written question that every ambulance service in England was at the highest alert level. We are now nine months on, and we are in that situation again. We are facing warnings of extreme weather this weekend. The Government need to reinstate the funding for discharge packages into social care homes. We need primary care to be used to stabilise people in communities, and we must be using first responders from the fire service. Will the Minister agree to convene an urgent meeting of Cobra today to protect patients and paramedics, who are really operating at the brink?

[Maria Caulfield]

I say to the hon. Lady that we have put additional investment this year—over £150 million of extra funding—into ambulance services to help them meet demand, because they do have significant demand. The rates we are seeing at this time of year are the sorts of rates we would normally see in winter, and we are doing exactly as we would then. We have our heatwave plan, which was published earlier this year, and we are confident that we are working with all NHS trusts, and all the ambulance trusts too, to make sure they have the support they need. Can I gently say to her that this is not just about funding? This is about bringing care together to ensure that hospital beds are freed up so that when ambulances arrive at A&E they can unload their patients. As I said to the shadow Secretary of State—I am not sure if he is going to take me up on this—I am happy to work with every single Member across this House to make sure that we support our emergency services.

Access to GP Services and NHS Dentistry

Debate between Maria Caulfield and Daisy Cooper

Tuesday 21st June 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

The Conservatives have been running our health and social care system into the ground for years. Covid has made an already bad situation worse, but it was already bad, and my constituents—patients and healthcare professionals—can really feel it. A constituent who is a professional chauffeur needs to provide regular medical assessment certificates to keep his job, but his GP is not doing them right now, so my team have had to work hard to make sure that his employer will not sack him.

Some of my constituents have managed to see their GPs. One has had a referral for chronic back pain, another for a diagnosis of breast cancer that needs treatment, but having had those appointments they then discovered weeks later that the referral letters were never sent. Another constituent who had a contraceptive implant has had some very severe side effects and wants to have it removed, but she cannot get an appointment. A constituent who contacted her GP to say that she was having suicidal thoughts was asked to fill out a form.

I was so concerned about these reports that I have been to visit our GP surgeries in St Albans. From the other end of the spectrum, it is incredibly shocking. The very second the phone lines open in a GP surgery, there are flashing lights on its big screen. At one minute past the time that its phone lines open, there are hundreds and hundreds of calls on the electronic board. Many of those phone calls are from very distressed callers who are in pain and very concerned. Many of the people at the counter—the receptionists at the other end of the phone—are receiving verbal abuse, and we know that GPs are receiving abuse in their surgery rooms behind closed doors as well. The BMJ suggests that violent incidents in GP surgeries have doubled in the last five years.

One of the GP surgeries in my constituency has now employed somebody on a full- time basis to do one job: to chase the local hospitals to send the letters so that the GPs can get the results that their patients need. We have heard Members across the House talk this afternoon about how fantastic it would be if we could use big data and if our constituents could become expert patients and use all the information collected on their phone, but frankly, at the moment, we are starting from a basis where we cannot even get a letter from a hospital to a GP surgery. It feels as though the entire system is creaking at the seams, and that is even before we get to the postcode lottery of the number of patients each GP has, or the length of appointments.

Members across the House have talked about the planning system and the fact that lots of new homes are often built in areas without the infrastructure to go with them. I wholeheartedly sympathise with the calls for new homes, but it seems crazy in the circumstances that clinical commissioning groups are not even statutory consultees for planning applications, for local plans or even for permitted development. It should be a priority for this Government to change that and make sure that CCGs have the right resources to respond to planning proposals.

Then we have the problems with dentists. Like many other Members use, I have constituents who have raised these problems. I have mothers with MAT-B certificates who cannot get dental treatment. I have parents whose children are developing gum disease, but they cannot get an appointment with their dentist. I have couples who have moved to St Albans and, because they have moved, cannot get an appointment with the dentist. The list goes on and on.

I have challenged the Minister before about the Government’s announcement earlier this year that they were going to give £50 million to dentists to create some emergency catch-up appointments. When the Secretary of State was challenged on this earlier this afternoon, he said that that £50 million had resulted in tens of thousands of new appointments. That was news to me. Earlier this year, I submitted a number of written parliamentary questions. I asked the Government how many dental practices had achieved the quarter 3 targets to make them eligible for this £50 million. The answer was that the Government did not hold that information centrally. I asked the Government how many expressions of interest had been received by the deadline of 3 January. The answer was that the Government did not hold that information centrally. I then asked the Government how many of those who had offered to carry out this urgent dental practice had been accepted. Again, the Government said that they did not hold that information centrally. So what has happened to that £50 million? How much of it has been drawn down?

[Maria Caulfield]

The hon. Lady will know, because she raised this in oral questions, that dentists return that data in quarters. We will have that data from the dental community by the end of June, and we will then be able to answer her questions. She knows that; she is making a political point here.

[Daisy Cooper]

I am genuinely incredibly grateful for that answer, because when I challenged the Minister on this last week I did not receive that answer. I am grateful to receive that response. I submitted a letter to the Minister—I think it was in April—and attempted to come to some drop-in events that were cancelled, so I am pleased to hear that that data will be provided by the end of June. However, my constituents in St Albans have seen absolutely zero appointments created from that money. Every dental practice has said that because of the way the funds have been set up, it has been impossible for them to apply for them. A number of other Members have raised that point.

The truth is that the Government have failed to recruit the GPs that we need. We have a retirement time bomb among our general practitioners, and we know that dentists are leaving NHS work as well. We need to see a serious plan from the Government so that everybody who needs to see a GP or a dentist can actually see one.

--- Later in debate ---

[Daisy Cooper]

Will the Minister give way?

[Maria Caulfield]

No, I will not.

We are also delivering zero tolerance to abuse through the Police, Crime, Sentencing and Courts Act 2022. Labour talk the talk, but it was those of us on the Government Benches who voted to double the maximum sentence for those who abuse our emergency care workers. Labour actually voted against giving the Bill a Third Reading. That tells us all we need to know.

With the time I have left—

Oral Answers to Questions

Debate between Maria Caulfield and Daisy Cooper

Tuesday 14th June 2022 Commons Chamber

[Maria Caulfield]

I am sure the people of Wakefield are as frustrated as I am that the Labour dental contract, put in place in 2006, is the nub of the problem. If the hon. Lady were to meet with dentists, she would hear loud and clear that the dental contract is causing the problem. [Interruption.] She might not have listened to my previous answers because she is not listening now, but we will be announcing changes before the summer recess.

[Daisy Cooper (St Albans) (LD)]

At the start of this year the Government announced £50 million to create some new dentistry appointments, but that money resulted in exactly zero new appointments in my constituency. I wrote to every single dental practice in my constituency and they said that was because the funding offer was too limited in scope and time and they were given only a week to reply.

On 25 April, I wrote to the Minister asking how many appointments had been created from this money across England and where that money had gone. I have not received an answer. Will we get one today?

[Maria Caulfield]

I am very disappointed: that £50 million of funding was for dentistry to access and be able to afford more appointments, and if local commissioners in an area did not bid for that money or ask dentists to take that money on, that is extremely disappointing—those in other parts of the country certainly did. We are putting £3 billion a year into dentistry. Local MPs have a role to play in this: if there was a problem, I would have expected the hon. Lady to have come and seen me before now to lobby for more funding for her local area.

North East Ambulance Service

Debate between Maria Caulfield and Daisy Cooper

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I reassure the hon. Gentleman that the police have investigated and that they did not find evidence of that. As I have said at the Dispatch Box, I will look into specific cases to be confident that no stone has been left unturned with respect to the allegations in The Sunday Times. There are measures in the Police, Crime, Sentencing and Courts Act 2022 that increase sentences for assaults on emergency workers, which we take extremely seriously.

[Daisy Cooper (St Albans) (LD)]

As far back as December last year, I wrote to the Secretary of State urging him to commission a CQC investigation of the crisis in our ambulance service, using his powers under the Health and Social Care Act 2008, because the CQC does not have powers to conduct thematic reviews itself. Since I wrote to him, we have seen scandal after scandal. In the north-east, people were told to phone a friend; in the west midlands, a patient waited more than 22 hours; in the south-west, stroke and heart attack victims are having to wait more than an hour; and in my own constituency, a cancer patient nearing the end of life had to wait almost 12 hours in agony for an ambulance to arrive. Surely it is time for the Government to stop sitting on their hands and to commission the CQC to launch a wide-ranging investigation of the crisis facing all our ambulance services.

[Maria Caulfield]

Let me reassure the hon. Lady. The CQC has been heavily involved in this case. I met representatives this morning to hear from them, and will be following that up. Moreover, an extra £55 million has been invested in the ambulance service nationally. We are aware of the pressures that the service is facing, and will do all that we can to support it.

Oral Answers to Questions

Debate between Maria Caulfield and Daisy Cooper

Tuesday 23rd November 2021 Commons Chamber

[Maria Caulfield]

I know that my hon. Friend has a personal interest in improving stroke services. I can reassure him that the national stroke service model was published by NHS England and NHS Improvement in May this year, and that as of 1 April there are 20 operational integrated stroke delivery networks, bringing together key stakeholders to improve the diagnosis, treatment and rehabilitation of those who have suffered a stroke.

[Daisy Cooper (St Albans) (LD)]

Ambulance response times are at their highest since records began. A month ago, on 22 October, I tabled a parliamentary question asking the Secretary of State how many ambulance trusts had moved into level 4—the level at which potential failures creep into the service. I am still awaiting an answer. Will the Minister answer that question today, please?